Addition of epinephrine to intrathecal bupivacaine and sufentanil for ambulatory labor analgesia
The intrathecal combination of sufentanil and bupivacaine provides rapid, effective analgesia for labor with a limited duration. Many anesthesiologists have concerns that the use of intrathecal local anesthetics precludes maternal ambulation. This prospective, randomized, double-blind study was desi...
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| Veröffentlicht in: | Anesthesiology (Philadelphia) 1997-03, Vol.86 (3), p.525-531 |
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| creator | CAMPBELL, D. C BANNER, R CRONE, L.-A GORE-HICKMAN, W YIP, R. W |
| description | The intrathecal combination of sufentanil and bupivacaine provides rapid, effective analgesia for labor with a limited duration. Many anesthesiologists have concerns that the use of intrathecal local anesthetics precludes maternal ambulation. This prospective, randomized, double-blind study was designed to determine whether the addition of epinephrine to the combination of sufentanil and bupivacaine would prolong intrathecal analgesia for labor. Patients' ability to ambulate was also assessed.
Thirty-nine patients received either an intrathecal control dose of 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml normal saline (control group); or 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml (0.2 mg) of epinephrine (EPI group).
Seven patients (3 control, 4 EPI) delivered vaginally and two (1 control, 1 EPI) required cesarean delivery before requesting epidural analgesia. The duration (mean +/- SD) of intrathecal labor analgesia was prolonged significantly by the addition of epinephrine: control (n = 15): 145 +/- 23 min; EPI (n = 15): 188 +/- 25 min (P < 0.0001). Maternal ambulation was demonstrated in 100% (19 of 19) of the control group and in 80% (16 of 20) of the EPI group (P = NS).
The addition of 0.2 mg epinephrine to the intrathecal combination of sufentanil and bupivacaine significantly prolonged labor analgesia without causing adverse effects to the mother or fetus. The intrathecal combination of sufentanil and bupivacaine, with or without epinephrine, provided rapid, profound labor analgesia and allowed most patients to ambulate. |
| doi_str_mv | 10.1097/00000542-199703000-00003 |
| format | Article |
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Thirty-nine patients received either an intrathecal control dose of 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml normal saline (control group); or 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml (0.2 mg) of epinephrine (EPI group).
Seven patients (3 control, 4 EPI) delivered vaginally and two (1 control, 1 EPI) required cesarean delivery before requesting epidural analgesia. The duration (mean +/- SD) of intrathecal labor analgesia was prolonged significantly by the addition of epinephrine: control (n = 15): 145 +/- 23 min; EPI (n = 15): 188 +/- 25 min (P < 0.0001). Maternal ambulation was demonstrated in 100% (19 of 19) of the control group and in 80% (16 of 20) of the EPI group (P = NS).
The addition of 0.2 mg epinephrine to the intrathecal combination of sufentanil and bupivacaine significantly prolonged labor analgesia without causing adverse effects to the mother or fetus. The intrathecal combination of sufentanil and bupivacaine, with or without epinephrine, provided rapid, profound labor analgesia and allowed most patients to ambulate.</description><identifier>ISSN: 0003-3022</identifier><identifier>EISSN: 1528-1175</identifier><identifier>DOI: 10.1097/00000542-199703000-00003</identifier><identifier>PMID: 9066317</identifier><identifier>CODEN: ANESAV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Ambulatory Care - methods ; Analgesia, Obstetrical - methods ; Anesthetics, Intravenous ; Anesthetics, Local ; Anesthetics. Neuromuscular blocking agents ; Biological and medical sciences ; Bupivacaine ; Double-Blind Method ; Drug Synergism ; Drug Therapy, Combination ; Epinephrine ; Female ; Humans ; Injections, Spinal ; Labor, Obstetric ; Medical sciences ; Neuropharmacology ; Pharmacology. Drug treatments ; Pregnancy ; Prospective Studies ; Sufentanil</subject><ispartof>Anesthesiology (Philadelphia), 1997-03, Vol.86 (3), p.525-531</ispartof><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-2f24731994b8b7c5cf78f62cce9478d1ee1736c9ec8b83a9f73594c8028a0e5b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2605696$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9066317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CAMPBELL, D. C</creatorcontrib><creatorcontrib>BANNER, R</creatorcontrib><creatorcontrib>CRONE, L.-A</creatorcontrib><creatorcontrib>GORE-HICKMAN, W</creatorcontrib><creatorcontrib>YIP, R. W</creatorcontrib><title>Addition of epinephrine to intrathecal bupivacaine and sufentanil for ambulatory labor analgesia</title><title>Anesthesiology (Philadelphia)</title><addtitle>Anesthesiology</addtitle><description>The intrathecal combination of sufentanil and bupivacaine provides rapid, effective analgesia for labor with a limited duration. Many anesthesiologists have concerns that the use of intrathecal local anesthetics precludes maternal ambulation. This prospective, randomized, double-blind study was designed to determine whether the addition of epinephrine to the combination of sufentanil and bupivacaine would prolong intrathecal analgesia for labor. Patients' ability to ambulate was also assessed.
Thirty-nine patients received either an intrathecal control dose of 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml normal saline (control group); or 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml (0.2 mg) of epinephrine (EPI group).
Seven patients (3 control, 4 EPI) delivered vaginally and two (1 control, 1 EPI) required cesarean delivery before requesting epidural analgesia. The duration (mean +/- SD) of intrathecal labor analgesia was prolonged significantly by the addition of epinephrine: control (n = 15): 145 +/- 23 min; EPI (n = 15): 188 +/- 25 min (P < 0.0001). Maternal ambulation was demonstrated in 100% (19 of 19) of the control group and in 80% (16 of 20) of the EPI group (P = NS).
The addition of 0.2 mg epinephrine to the intrathecal combination of sufentanil and bupivacaine significantly prolonged labor analgesia without causing adverse effects to the mother or fetus. The intrathecal combination of sufentanil and bupivacaine, with or without epinephrine, provided rapid, profound labor analgesia and allowed most patients to ambulate.</description><subject>Adult</subject><subject>Ambulatory Care - methods</subject><subject>Analgesia, Obstetrical - methods</subject><subject>Anesthetics, Intravenous</subject><subject>Anesthetics, Local</subject><subject>Anesthetics. Neuromuscular blocking agents</subject><subject>Biological and medical sciences</subject><subject>Bupivacaine</subject><subject>Double-Blind Method</subject><subject>Drug Synergism</subject><subject>Drug Therapy, Combination</subject><subject>Epinephrine</subject><subject>Female</subject><subject>Humans</subject><subject>Injections, Spinal</subject><subject>Labor, Obstetric</subject><subject>Medical sciences</subject><subject>Neuropharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>Sufentanil</subject><issn>0003-3022</issn><issn>1528-1175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEtPAyEUhYnR1Fr9CSYs3I7yGAZYNo2vpIkbXY8XBixmykxgatJ_74ytvQtuzjkcEj6EMCX3lGj5QKYRJSuo1pLwURSTw8_QnAqmCkqlOEfzySo4YewSXeX8PUopuJqhmSZVxamco89l04QhdBF3Hrs-RNdv0njiocMhDgmGjbPQYrPrww9YmCKIDc477-IAMbTYdwnD1uxaGLq0xy2YyYjQfrkc4BpdeGizuznuBfp4enxfvRTrt-fX1XJdWK70UDDPSsnH35RGGWmF9VL5ilnrdClVQ52jkldWO6uM4qC95EKXVhGmgDhh-AKpw7s2dTkn5-s-hS2kfU1JPTGr_5nVJ2Z_Fh-rt4dqvzNb15yKR0hjfnfMIY8sfIJoQz5dYxURla74L9nWdUA</recordid><startdate>19970301</startdate><enddate>19970301</enddate><creator>CAMPBELL, D. C</creator><creator>BANNER, R</creator><creator>CRONE, L.-A</creator><creator>GORE-HICKMAN, W</creator><creator>YIP, R. W</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>19970301</creationdate><title>Addition of epinephrine to intrathecal bupivacaine and sufentanil for ambulatory labor analgesia</title><author>CAMPBELL, D. C ; BANNER, R ; CRONE, L.-A ; GORE-HICKMAN, W ; YIP, R. W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-2f24731994b8b7c5cf78f62cce9478d1ee1736c9ec8b83a9f73594c8028a0e5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Ambulatory Care - methods</topic><topic>Analgesia, Obstetrical - methods</topic><topic>Anesthetics, Intravenous</topic><topic>Anesthetics, Local</topic><topic>Anesthetics. Neuromuscular blocking agents</topic><topic>Biological and medical sciences</topic><topic>Bupivacaine</topic><topic>Double-Blind Method</topic><topic>Drug Synergism</topic><topic>Drug Therapy, Combination</topic><topic>Epinephrine</topic><topic>Female</topic><topic>Humans</topic><topic>Injections, Spinal</topic><topic>Labor, Obstetric</topic><topic>Medical sciences</topic><topic>Neuropharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>Sufentanil</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CAMPBELL, D. C</creatorcontrib><creatorcontrib>BANNER, R</creatorcontrib><creatorcontrib>CRONE, L.-A</creatorcontrib><creatorcontrib>GORE-HICKMAN, W</creatorcontrib><creatorcontrib>YIP, R. W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CAMPBELL, D. C</au><au>BANNER, R</au><au>CRONE, L.-A</au><au>GORE-HICKMAN, W</au><au>YIP, R. W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Addition of epinephrine to intrathecal bupivacaine and sufentanil for ambulatory labor analgesia</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>1997-03-01</date><risdate>1997</risdate><volume>86</volume><issue>3</issue><spage>525</spage><epage>531</epage><pages>525-531</pages><issn>0003-3022</issn><eissn>1528-1175</eissn><coden>ANESAV</coden><abstract>The intrathecal combination of sufentanil and bupivacaine provides rapid, effective analgesia for labor with a limited duration. Many anesthesiologists have concerns that the use of intrathecal local anesthetics precludes maternal ambulation. This prospective, randomized, double-blind study was designed to determine whether the addition of epinephrine to the combination of sufentanil and bupivacaine would prolong intrathecal analgesia for labor. Patients' ability to ambulate was also assessed.
Thirty-nine patients received either an intrathecal control dose of 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml normal saline (control group); or 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml (0.2 mg) of epinephrine (EPI group).
Seven patients (3 control, 4 EPI) delivered vaginally and two (1 control, 1 EPI) required cesarean delivery before requesting epidural analgesia. The duration (mean +/- SD) of intrathecal labor analgesia was prolonged significantly by the addition of epinephrine: control (n = 15): 145 +/- 23 min; EPI (n = 15): 188 +/- 25 min (P < 0.0001). Maternal ambulation was demonstrated in 100% (19 of 19) of the control group and in 80% (16 of 20) of the EPI group (P = NS).
The addition of 0.2 mg epinephrine to the intrathecal combination of sufentanil and bupivacaine significantly prolonged labor analgesia without causing adverse effects to the mother or fetus. The intrathecal combination of sufentanil and bupivacaine, with or without epinephrine, provided rapid, profound labor analgesia and allowed most patients to ambulate.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>9066317</pmid><doi>10.1097/00000542-199703000-00003</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Anesthesiology (Philadelphia), 1997-03, Vol.86 (3), p.525-531 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | Adult Ambulatory Care - methods Analgesia, Obstetrical - methods Anesthetics, Intravenous Anesthetics, Local Anesthetics. Neuromuscular blocking agents Biological and medical sciences Bupivacaine Double-Blind Method Drug Synergism Drug Therapy, Combination Epinephrine Female Humans Injections, Spinal Labor, Obstetric Medical sciences Neuropharmacology Pharmacology. Drug treatments Pregnancy Prospective Studies Sufentanil |
| title | Addition of epinephrine to intrathecal bupivacaine and sufentanil for ambulatory labor analgesia |
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